The effect of cognitive-behavioral group training of self-care skills on self-care in patients with schizophrenia
,
Abstract
Background & Aim: Self-care is one of the challenges of the health care system in patients with schizophrenia. It has been less studied due to these patients have no insight into the symptoms. This study aimed to determine the effect of cognitive-behavioral group training of self-care skills on self-care in patients with schizophrenia.
Methods & Materials: This single-blind randomized controlled clinical trial (blinding of data analysts) was performed on 50 hospitalized schizophrenia patients by convenience sampling method and random block allocation to the intervention (n=26) and control (n=24) groups in Ebn-Sina Psychiatric Hospital of Mashhad, Iran from late July 2020 to mid-January 2021. The intervention group received cognitive-behavioral group training of self-care skills based on the protocol by Kashani Lotfabadi et al. (2020) in 10 sessions (two sessions per week). The control group was placed on a waiting list. Data collection tools included the Self-Care Requisites Scale (SCRS-H) and the Positive and Negative Syndrome Scale (PANSS). The data were analyzed by SPSS 25 version, repeated measures of ANOVA test.
Results: 60 % (n=30) of participants were female, and 40% (n=20) were male with a mean age of 32.98±8.35 years. The results of repeated measures of ANOVA indicated that there was a significant difference between the intervention and control groups in terms of descending mean score of total self-care during the test stages (p=0.001).
Conclusion: Cognitive-behavioral group training of self-care skills could promote self-care behaviors in patients with schizophrenia. Therefore, we suggest using this intervention to strengthen self-care skills in patients with schizophrenia.
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3. Su CC, Bai YM, Chou MH, Wang JD, Yang YK. Estimate dynamic changes of dysfunction and lifelong spent for psychiatric care needs in patients with schizophrenia. Eur Psychiatry. 2018 Oct;54:65-70.
4. Chu K-Y, Yang N-P, Chou P, Chiu H-J, Chi L-Y. Oral-health status of inpatients with schizophrenia in Taiwan. Journal of Dental Sciences. 2011;6(3):170-5.
5. Baruah A, Bhaduri A, Deuri S. Effect of psycho-educative intervention on knowledge about illness and self-care in patients with schizophrenia. Nursing Journal of India. 2012;103(4):188-90.
6. Ayres H, Ngo H, John AP. Limited changes in activities of daily life performance ability among people with schizophrenia at clinical settings and the factors moderating the changes. Schizophrenia Research: Cognition. 2019;16:29-35.
7. Lipskaya L, Jarus T, Kotler M. Influence of cognition and symptoms of schizophrenia on IADL performance. Scandinavian Journal of Occupational Therapy. 2011;18(3):180-7.
8. Putri NAR, Kurnianingsih T, Andayani S. Daily Living Performance in Schizophrenic Patients in Correlation with Positive and Negative Symptoms. Althea Medical Journal. 2020;7(2):72-8.
9. Hsu Y-C, Lin W-Q, Kuo H-W. Schizophrenic Patients’ Poor Perception in Personal Hygiene. Ment Health Fam Med. 2017;13(1):369-74.
10. Taş S, Buldukoğlu K. Early period self-care ability and care requirements of schizophrenia patients after discharge. Journal of Psychiatric Nursing. 2018;9(1):11-22.
11. Ausili D, Masotto M, Dall'Ora C, Salvini L, Di Mauro S. A literature review on self-care of chronic illness: definition, assessment and related outcomes. Professioni Infermieristiche. 2014;67(3):180-9.
12. Riegel B, Dunbar SB, Fitzsimons D, Freedland KE, Lee CS, Middleton S, et al. Self-care research: Where are we now? Where are we going? International Journal of Nursing Studies. 2019:103402.
13. Orem D, SG ST, Renpenning K. Nursing Concept of Practice. Sixth Edition ed. Mosby A Harcout Health Science Company: ST. Louis; 2001.
14. Donato K. Self-Care as a Burdened Virtue. Episteme. 2017;28(1):3.
15. Yoshii H, Kitamura N, Akazawa K, Saito H. Effects of an educational intervention on oral hygiene and self-care among people with mental illness in Japan: a longitudinal study. BMC oral health. 2017;17(1):81.
16. Matthews J, Hall AM, Keogh A. Evaluating the effects of behavior change training on the knowledge, confidence and skills of sport and exercise science students. BMC Sports Science, Medicine and Rehabilitation. 2020;12(1):1-10.
17. Chen SR, Chien YP, Kang CM, Jeng C, Chang WY. Comparing self-efficacy and self-care behaviours between outpatients with comorbid schizophrenia and type 2 diabetes and outpatients with only type 2 diabetes. J Psychiatr Ment Health Nurs. 2014;21(5):414-22.
18. Rathod S, Phiri P, Kingdon D. Cognitive behavioral therapy for schizophrenia. Psychiatric Clinics. 2010;33(3):527-36.
19. Steel C. CBT for schizophrenia: Evidence-based interventions and future directions: John Wiley & Sons; 2012.
20. Candida M, Campos C, Monteiro B, Rocha NBF, Paes F, Nardi AE, et al. Cognitive-behavioral therapy for schizophrenia: an overview on efficacy, recent trends and neurobiological findings. Medical Express. 2016;3(5).
21. Lodha P, De Sousa A. Cognitive Behavioural Therapy and Its Role in the Outcome and Recovery from Schizophrenia. Schizophrenia Treatment Outcomes: Springer; 2020. p. 299-312.
22. Addington J, Epstein I, Liu L, French P, Boydell KM, Zipursky RB. A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia research. 2011;125(1):54-61.
23. Nozaki C, Oka M, Chaboyer W. The effects of a cognitive behavioural therapy programme for self‐care on haemodialysis patients. International journal of nursing practice. 2005;11(5):228-36.
24. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Internal Medicine. 2015;175(11):1773-82.
25. Naeem F, Khoury B, Munshi T, Ayub M, Lecomte T, Farooq S. Brief Cognitive Behavioral Therapy for Psychosis (CBTp) for Schizophrenia: Literature Review and Meta-analysis. International Journal of Cognitive Therapy. 2016;9:73-86.
26. Kashani-Lotfabadi M, Talaei A, Modares-Gharavi M, Aboozarian S-S, Mohammadi A, Hashemi BM, et al. The Effectiveness of Cognitive-Behavioral Group Therapy on Improving Self-Care Skills among Women with Chronic Schizophrenia. International Journal of Behavioral Sciences. 2020;13(4):135-41.
27. Granholm E, Ben-Zeev D, Link PC. Social disinterest attitudes and group cognitive-behavioral social skills training for functional disability in schizophrenia. Schizophrenia Bulletin. 2009;35(5):874-83.
28. Roldán‐Merino J, Miguel‐Ruiz D, Lluch‐Canut MT, Puig‐Llobet M, Feria‐Raposo I, Group QW, et al. Psychometric Properties of S elf‐C are R equisites S cale (SCRS‐h) in Hospitalized Patients Diagnosed With Schizophrenia. Perspectives in Psychiatric Care. 2017;53(1):16-28.
29. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin. 1987;13(2):261-76.
30. Peralta V, Cuesta MJ. Psychometric properties of the positive and negative syndrome scale (PANSS) in schizophrenia. Psychiatry Research. 1994;53(1):31-40.
31. Safa SG, Iravani M, Bargard MS, Latify M. Efficacy of Cognitive Behavioral Therapy-Based SelfManagement Intervention on Labor Outcome in Nulliparous Women. J Mazandaran Univ Med Sci 2018;28(160):132-23 (Persian).
32. Samadzade N, Poursharifi H, Poursharifi H. The effect of cognitive-behavioral therapy on the self-care behaviors and symptoms of depression and anxiety in women with type 2 diabetes: a case study Journal of Kashan University of Medical Sciences. 2015;19(3):255-64.
33. Enomoto T, Tatara A, Goda M, Nishizato Y, Nishigori K, Kitamura A, et al. A Novel Phosphodiesterase 1 Inhibitor DSR-141562 Exhibits Efficacies in Animal Models for Positive, Negative, and Cognitive Symptoms Associated with Schizophrenia. Journal of Pharmacology and Experimental Therapeutics. 2019;371(3):692-702.
34. Aubin G, Stip E, Gélinas I, Rainville C, Chapparo C. Daily activities, cognition and community functioning in persons with schizophrenia. Schizophrenia research. 2009;107(2-3):313-8.
35. Strassnig MT, Raykov T, O'Gorman C, Bowie CR, Sabbag S, Durand D, et al. Determinants of different aspects of everyday outcome in schizophrenia: the roles of negative symptoms, cognition, and functional capacity. Schizophrenia Research. 2015;165(1):76-82.
36. Rabinowitz J, Levine SZ, Garibaldi G, Bugarski-Kirola D, Berardo CG, Kapur S. Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: analysis of CATIE data. Schizophrenia Research. 2012;137(1-3):147-50.
37. Mlinac ME, Feng MC. Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology. 2016;31(6):506-16.
38. Viertiö S, Tuulio-Henriksson A, Perälä J, Saarni SI, Koskinen S, Sihvonen M, et al. Activities of daily living, social functioning and their determinants in persons with psychotic disorder. European Psychiatry. 2012;27(6):409-15.
39. Lavelle M, Healey PG, McCabe R. Is nonverbal communication disrupted in interactions involving patients with schizophrenia? Schizophrenia Bulletin. 2013;39(5):1150-8.
40. Granholm E, Holden J, Link PC, McQuaid JR. Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology. 2014;82(6):1173.
41. Orfanos S, Banks C, Priebe S. Are group psychotherapeutic treatments effective for patients with schizophrenia? A systematic review and meta-analysis. Psychotherapy and Psychosomatics. 2015;84(4):241-9.
42. Kim Y-s, Park J-H, Lee S-A. Is a program to improve grocery-shopping skills clinically effective in improving executive function and instrumental activities of daily living of patients with schizophrenia? Asian Journal of Psychiatry. 2020;48:101896.
2. Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, McGrath JJ, Whiteford HA. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophr Bull. 2018 Oct 17;44(6):1195-1203.
3. Su CC, Bai YM, Chou MH, Wang JD, Yang YK. Estimate dynamic changes of dysfunction and lifelong spent for psychiatric care needs in patients with schizophrenia. Eur Psychiatry. 2018 Oct;54:65-70.
4. Chu K-Y, Yang N-P, Chou P, Chiu H-J, Chi L-Y. Oral-health status of inpatients with schizophrenia in Taiwan. Journal of Dental Sciences. 2011;6(3):170-5.
5. Baruah A, Bhaduri A, Deuri S. Effect of psycho-educative intervention on knowledge about illness and self-care in patients with schizophrenia. Nursing Journal of India. 2012;103(4):188-90.
6. Ayres H, Ngo H, John AP. Limited changes in activities of daily life performance ability among people with schizophrenia at clinical settings and the factors moderating the changes. Schizophrenia Research: Cognition. 2019;16:29-35.
7. Lipskaya L, Jarus T, Kotler M. Influence of cognition and symptoms of schizophrenia on IADL performance. Scandinavian Journal of Occupational Therapy. 2011;18(3):180-7.
8. Putri NAR, Kurnianingsih T, Andayani S. Daily Living Performance in Schizophrenic Patients in Correlation with Positive and Negative Symptoms. Althea Medical Journal. 2020;7(2):72-8.
9. Hsu Y-C, Lin W-Q, Kuo H-W. Schizophrenic Patients’ Poor Perception in Personal Hygiene. Ment Health Fam Med. 2017;13(1):369-74.
10. Taş S, Buldukoğlu K. Early period self-care ability and care requirements of schizophrenia patients after discharge. Journal of Psychiatric Nursing. 2018;9(1):11-22.
11. Ausili D, Masotto M, Dall'Ora C, Salvini L, Di Mauro S. A literature review on self-care of chronic illness: definition, assessment and related outcomes. Professioni Infermieristiche. 2014;67(3):180-9.
12. Riegel B, Dunbar SB, Fitzsimons D, Freedland KE, Lee CS, Middleton S, et al. Self-care research: Where are we now? Where are we going? International Journal of Nursing Studies. 2019:103402.
13. Orem D, SG ST, Renpenning K. Nursing Concept of Practice. Sixth Edition ed. Mosby A Harcout Health Science Company: ST. Louis; 2001.
14. Donato K. Self-Care as a Burdened Virtue. Episteme. 2017;28(1):3.
15. Yoshii H, Kitamura N, Akazawa K, Saito H. Effects of an educational intervention on oral hygiene and self-care among people with mental illness in Japan: a longitudinal study. BMC oral health. 2017;17(1):81.
16. Matthews J, Hall AM, Keogh A. Evaluating the effects of behavior change training on the knowledge, confidence and skills of sport and exercise science students. BMC Sports Science, Medicine and Rehabilitation. 2020;12(1):1-10.
17. Chen SR, Chien YP, Kang CM, Jeng C, Chang WY. Comparing self-efficacy and self-care behaviours between outpatients with comorbid schizophrenia and type 2 diabetes and outpatients with only type 2 diabetes. J Psychiatr Ment Health Nurs. 2014;21(5):414-22.
18. Rathod S, Phiri P, Kingdon D. Cognitive behavioral therapy for schizophrenia. Psychiatric Clinics. 2010;33(3):527-36.
19. Steel C. CBT for schizophrenia: Evidence-based interventions and future directions: John Wiley & Sons; 2012.
20. Candida M, Campos C, Monteiro B, Rocha NBF, Paes F, Nardi AE, et al. Cognitive-behavioral therapy for schizophrenia: an overview on efficacy, recent trends and neurobiological findings. Medical Express. 2016;3(5).
21. Lodha P, De Sousa A. Cognitive Behavioural Therapy and Its Role in the Outcome and Recovery from Schizophrenia. Schizophrenia Treatment Outcomes: Springer; 2020. p. 299-312.
22. Addington J, Epstein I, Liu L, French P, Boydell KM, Zipursky RB. A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia research. 2011;125(1):54-61.
23. Nozaki C, Oka M, Chaboyer W. The effects of a cognitive behavioural therapy programme for self‐care on haemodialysis patients. International journal of nursing practice. 2005;11(5):228-36.
24. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Internal Medicine. 2015;175(11):1773-82.
25. Naeem F, Khoury B, Munshi T, Ayub M, Lecomte T, Farooq S. Brief Cognitive Behavioral Therapy for Psychosis (CBTp) for Schizophrenia: Literature Review and Meta-analysis. International Journal of Cognitive Therapy. 2016;9:73-86.
26. Kashani-Lotfabadi M, Talaei A, Modares-Gharavi M, Aboozarian S-S, Mohammadi A, Hashemi BM, et al. The Effectiveness of Cognitive-Behavioral Group Therapy on Improving Self-Care Skills among Women with Chronic Schizophrenia. International Journal of Behavioral Sciences. 2020;13(4):135-41.
27. Granholm E, Ben-Zeev D, Link PC. Social disinterest attitudes and group cognitive-behavioral social skills training for functional disability in schizophrenia. Schizophrenia Bulletin. 2009;35(5):874-83.
28. Roldán‐Merino J, Miguel‐Ruiz D, Lluch‐Canut MT, Puig‐Llobet M, Feria‐Raposo I, Group QW, et al. Psychometric Properties of S elf‐C are R equisites S cale (SCRS‐h) in Hospitalized Patients Diagnosed With Schizophrenia. Perspectives in Psychiatric Care. 2017;53(1):16-28.
29. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin. 1987;13(2):261-76.
30. Peralta V, Cuesta MJ. Psychometric properties of the positive and negative syndrome scale (PANSS) in schizophrenia. Psychiatry Research. 1994;53(1):31-40.
31. Safa SG, Iravani M, Bargard MS, Latify M. Efficacy of Cognitive Behavioral Therapy-Based SelfManagement Intervention on Labor Outcome in Nulliparous Women. J Mazandaran Univ Med Sci 2018;28(160):132-23 (Persian).
32. Samadzade N, Poursharifi H, Poursharifi H. The effect of cognitive-behavioral therapy on the self-care behaviors and symptoms of depression and anxiety in women with type 2 diabetes: a case study Journal of Kashan University of Medical Sciences. 2015;19(3):255-64.
33. Enomoto T, Tatara A, Goda M, Nishizato Y, Nishigori K, Kitamura A, et al. A Novel Phosphodiesterase 1 Inhibitor DSR-141562 Exhibits Efficacies in Animal Models for Positive, Negative, and Cognitive Symptoms Associated with Schizophrenia. Journal of Pharmacology and Experimental Therapeutics. 2019;371(3):692-702.
34. Aubin G, Stip E, Gélinas I, Rainville C, Chapparo C. Daily activities, cognition and community functioning in persons with schizophrenia. Schizophrenia research. 2009;107(2-3):313-8.
35. Strassnig MT, Raykov T, O'Gorman C, Bowie CR, Sabbag S, Durand D, et al. Determinants of different aspects of everyday outcome in schizophrenia: the roles of negative symptoms, cognition, and functional capacity. Schizophrenia Research. 2015;165(1):76-82.
36. Rabinowitz J, Levine SZ, Garibaldi G, Bugarski-Kirola D, Berardo CG, Kapur S. Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: analysis of CATIE data. Schizophrenia Research. 2012;137(1-3):147-50.
37. Mlinac ME, Feng MC. Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology. 2016;31(6):506-16.
38. Viertiö S, Tuulio-Henriksson A, Perälä J, Saarni SI, Koskinen S, Sihvonen M, et al. Activities of daily living, social functioning and their determinants in persons with psychotic disorder. European Psychiatry. 2012;27(6):409-15.
39. Lavelle M, Healey PG, McCabe R. Is nonverbal communication disrupted in interactions involving patients with schizophrenia? Schizophrenia Bulletin. 2013;39(5):1150-8.
40. Granholm E, Holden J, Link PC, McQuaid JR. Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology. 2014;82(6):1173.
41. Orfanos S, Banks C, Priebe S. Are group psychotherapeutic treatments effective for patients with schizophrenia? A systematic review and meta-analysis. Psychotherapy and Psychosomatics. 2015;84(4):241-9.
42. Kim Y-s, Park J-H, Lee S-A. Is a program to improve grocery-shopping skills clinically effective in improving executive function and instrumental activities of daily living of patients with schizophrenia? Asian Journal of Psychiatry. 2020;48:101896.
| Files | ||
| Issue | Vol 9 No 1 (2022): Winter | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v9i1.7327 | |
| Keywords | ||
| cognitive-behavioral therapy; schizophrenia; self-care; training | ||
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How to Cite
1.
Kashani Lotfabadi M, Bayazi MH, Rajaei AR. The effect of cognitive-behavioral group training of self-care skills on self-care in patients with schizophrenia. NPT. 2021;9(1):24-36.
